Healthcare Provider Details

I. General information

NPI: 1013938570
Provider Name (Legal Business Name): NORTHEAST HOMECARE INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/21/2006
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

RT 32 BRYANTS COUNTRY SQUARE
GREENVILLE NY
12083
US

IV. Provider business mailing address

RT 32 BRYANTS COUNTRY SQUARE
GREENVILLE NY
12083
US

V. Phone/Fax

Practice location:
  • Phone: 518-966-4808
  • Fax: 518-966-4813
Mailing address:
  • Phone: 518-966-4808
  • Fax: 518-966-4813

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number StateNY

VIII. Authorized Official

Name: GERRY ELSBREE
Title or Position: MANAGER
Credential:
Phone: 518-966-4808